Discinesia tardiva: epidemiologia clinica, fattori di rischio e gestione terapeutica

Abstract

Introduction Tardive dyskinesia (TD) is a heterogeneous, iatrogenic nosographic entity characterized by a vast repertoire of movements and involuntary movement disorders. It is caused by exposure to pharmacological agents that block dopamine receptors. TD is profoundly disabling and sometimes fatal, even when the drug considered responsible for the symptoms is discontinued. Although second-generation antipsychotic agents are significantly less likely to provoke TD than their first-generation counterparts, recent findings indicate that the incidence of dyskinetic symptoms is also significant in patients receiving atypical antipsychotic drugs. Given the importance of drug therapy in the management of schizophrenia and other psychiatric disorders and the impact of dyskinesia on the quality of life of patients, it is fundamental to define evidence-based interventions that are acceptable to both patients and physicians and that will reduce the incidence of the phenomenon and at the same time encourage adherence to the treatment regimen. Materials and methods We carried out a systematic review of studies on the diagnosis, prevention, and/or treatment of TD published between 1982 and 2011. Results Primary and secondary prevention strategies are fundamental in the management of TD. There is also a large body of scientific literature on the pharmacological management of dyskinetic complications, although it is by no means conclusive. Effectively addressing the issue of quality of life in patients with TD will require more in-depth investigation of the etiological factors and evolution of the currently available treatment options.